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In this study, we seek to illuminate: (1) the ways farm service providers and mental health professionals understand the drivers of farm stress, (2) the strategies, challenges, and opportunities farm service providers and mental health professionals identify for supporting the mental health needs of farm families, and; (3) opportunities for future research and outreach to improve the mental health of farmers in the U.S. Midwest region. We obtained qualitative data from a series of semi-structured key informant interviews with 19 subject matter experts, using content analysis to identify themes across four domains: main challenges, unique impacts by subpopulation, coping strategies, and interventions and recommendations. The key informants we interviewed identified a variety of acute and chronic stressors, including several that are structural, rather than individual and interpersonal, and which lie outside of the control of farmers themselves. They also highlighted diversity within farm populations by socio-demographic and farm characteristics as well as positive and negative coping strategies, with negative being more common. For interventions and recommendations, they stressed the importance of education on mental health, improving access to care, and addressing root causes of stress. While farmer stress is well-documented, less is known about the perspectives of farm service professionals and mental health providers who care for them. The insights from this study add important information on how to best support the immediate and long-term mental health needs of farmers and farm families in the U.S. Midwest and beyond. [ABSTRACT FROM AUTHOR]

In the midst of the COVID-19 pandemic, farmers and farm workers have been deemed essential workers across the world. Yet, despite working in one of the most dangerous occupations, and despite being especially vulnerable to the virus (due to existing health risk factors and risk of infection stemming from difficulties adopting control measures), many farmers and farm workers in the United States have long lacked essential resources to ensure they can meet their health needs: affordable and accessible health insurance and health care. In this commentary, we draw on our own research focused on farm families and collective experiences to discuss three main challenges farm families have faced meeting their health needs: reliance on off-farm work for health insurance coverage, the need to forecast income when purchasing a plan on the health insurance marketplace, and barriers to health care in rural areas. As we discuss these challenges, we highlight the ways in which the COVID-19 pandemic is likely exacerbating these pressures. Recognizing that major crises in the past have led to major shifts in economic, social, and political systems, the disruptions brought on by COVID-19 could be leveraged to work toward increasing access to affordable and adequate health insurance and health care. As such, we conclude our commentary by outlining policy reforms and research efforts that are needed to ensure that those working in the farm sector have access to essential resources to preserve their health and safety. [ABSTRACT FROM AUTHOR]